Organization
MPKM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW HOGAN PETERS (OWNER)
(702) 203-4797
Entity
Organization
Contact information
Practice address
10000 SE MAIN ST STE 118, PORTLAND, OR 97216-2462
(702) 203-4797
Mailing address
608 SARI DR, LAS VEGAS, NV 89110-4227
(702) 203-4797
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0000689-C
OR
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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